The role of new zinc incorporated monetite cements on osteogenic differentiation of human mesenchymal stem cells.

ß-Tricalcium phosphate particles were sintered in the presence of different amounts (0-0.72mol) of zinc oxide (ZnO) to prepare zinc doped ß-TCP (Znß-TCP) particles for further use in novel monetite (DCPA: CaHPO4) zinc incorporated bone cements with osteogenic differentiation potential towards human mesenchymal stem cells (hMSCs). XRD analysis of zinc incorporated cements prepared with ß-TCP reagent particles doped with different amount of ZnO (i.e. 0.03, 0.09 and 0.18mol ZnO) revealed the presence of unreacted Znß-TCP and monetite. Furthermore, it was shown that zinc ions preferentially occupied the ß-TCP crystal lattice rather than the monetite one. Release experiments indicated a burst release of ions from the different fabricated cements during the first 24h of immersion with zinc concentrations ranging between 85 and 100% of the total concentration released over a period of 21days. Cell proliferation significantly increased (P<0.05) on zinc incorporated monetite respect to control samples (Zinc-free cement) at 7 and 14days post seeding. The expression of Runx-2 was significantly up regulated (P<0.05) in the case of cells seeded on monetite prepared with ß-TCP doped with 0.03 moles of ZnO. On the other hand, the cell mineralization as well as the expression of osteogenic marker genes ALP and OSC decreased significantly (P<0.05) at 14days post cell seeding. In conclusion, these results suggest that the zinc ions released from the cements during the first 24h of culture played a critical role in regulating the osteogenic differentiation of hMSCs.

[Recurrent digestive hemorrhage of jejunal angioma]. / Emorragia digestiva ricorrente da angioma del digiuno.

A case of obscure recurrent gastrointestinal bleeding in a 78 year old man is reported. Selective mesenteric angiography made it possible to identify the site of hemorrhage in the upper jejunum. The pre- and intraoperative problems in case of small bowel vascular lesions are reviewed.

[Comparison of iopamidol 150 and 370 with the same iodine dosage (37 g) in urography]. / Confronto tra iopamidolo 150 e 370 alla stessa dose di iodio (37 g) nell'urografia.

Two different volumes of iopamidol (250 and 100 ml, respectively) containing 37.5 and 37 g of iodine in different concentrations (150 mgI/ml and 370 mgI/ml) were injected in the same time (10 minutes) with varying injection rates, to compare diagnostic effectiveness, image quality, distension of the collecting system, and influence of the better iodine concentration. Sixty patients of both sexes were randomly subdivided into two groups. Their renal function, blood pressure and pulse rate were normal. Their weight ranged 55-85 kg, not to change the distribution volume of the contrast medium. None of them had been given iodine compounds recently. Radiographs were taken 2, 5, 15, 25, and 30 minutes after the end of the injection. The image quality of nephrograms, pyelograms, bladder views and the degree of collecting system filling were evaluated by a blind study, using grading scores (0 to 3). In both groups image quality and degree of filling were satisfying; the volume of injected iopamidol had poor significance. The clinical findings confirm that, with a nonionic contrast medium, iodine concentration in the collecting system is the most important factor for image quality.

[Use of ultrasonography in the diagnosis of acute appendicitis]. / Impiego dell'ecotomografia nella diagnosi di appendicite acuta.

To date, the diagnosis of acute appendicitis (AA) has been made primarily on clinical grounds and imaging techniques have been considered less useful. This paper is aimed at evaluating US utility in the diagnosis of AA. US scans of the appendix, after Puylaert, were obtained in 30 healthy subjects (group A), in 49 patients with recurrent pain in the iliac fossa (group B), and in 28 patients with clinical signs highly suggestive of AA (group C). In none of the subjects in group A was the appendix seen. Neither was it demonstrated in the patients in group B, all of whom underwent surgery and never presented with suppurating, phlegmonous, gangrenous, perforating AA and/or abscess. In the patients in group C, 20 of whom had a positive histology for AA, US demonstrated 17 true positive, 8 true negatives and 3 false negatives. We consider as useful in the diagnosis of AA the following US signs: 1) the appendix cannot be demonstrated, in which case AA is to be excluded; 2) the appendix can be seen and is still, non-compressible and exhibits thickened walls; 3) the appendix contains fecaliths. The latter 2 findings are suggestive of AA. Thus, US of the appendix is useful (100% specificity in group B) in excluding AA when clinical diagnosis is questionable, but the method proves less reliable (85% sensitivity in group C) when clinical presentation is more definite.